PL-20: Laparoscopic adjustable gastric banding does not cause esophageal dysmotility

Abstract

Background: Esophageal dilatation and dysmotility have been proposed as a potential complication of laparoscopic gastric banding (LAGB). The effect of the operation on the esophageal motility remains still uncertain. We hypothesized that: a) esophageal dysmotility after LAGB does not occur; b) esophageal manometry (EM) and barium esophagogram (BE) are both required pre and postoperatively to rule out dismotility; and c) fluoroscopic guidance is mandatory during band adjustment. Methods: Between 1/01 and 10/06, 829 patients underwent LAGB. Preoperatively EM and BE were performed. Forty patients underwent repeat EM at 1 year. BE was consistently performed during adjustments. Results: 829 pts underwent EM before LAGB: LESP was 16 7 mmHg; 56% had normal peristalsis, 37% NSEMD, 4% HP and 3% IEM; DEA was 83 38 mmHg. Of the 40 pts who had EM at 1 year, 85% were women, age 41 42 years, preoperative BMI was 47 47 kg/m2. At 17 14 months the % excess body weight loss (% EBWL) was 40 39. Postoperatively, 4 pts (18%) showed esophageal dilatation on esophagram. The results of the manometry were as follows: Conclusion: Our study suggested that, a) LAGB does not adversely affect esophageal motility; b) esophageal manometry is required to rule out esophageal motility disorders after LAGB; and c) in spite of using fluoroscopic guidance during band adjustments, esophageal dilatation still can occur.